Fracture plates, systems, and methods

ABSTRACT

Devices, systems, and methods of bone stabilization. The bone stabilization system includes a bone plate having an upper surface and a lower surface configured to be in contact with bone, the bone plate having an opening extending from the upper surface to the lower surface. The opening is configured to receive a fastener, which may be either a locking fastener or a compression fastener. The locking fastener has a threaded head portion configured to engage and lock to the bone plate, and the compression fastener is configured to dynamically compress the bone.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation-in-part of U.S. patentapplication Ser. No. 15/405,368, filed Jan. 13, 2017, which is acontinuation-in-part of U.S. patent application Ser. No. 15/238,772,filed Aug. 17, 2016, which are hereby incorporated by reference in theirentireties for all purposes.

FIELD

The present disclosure relates to surgical devices, and moreparticularly, stabilization systems, for example, for traumaapplications.

BACKGROUND

Bone fractures are often repaired by internal fixation of the bone, suchas diaphyseal bone, including tibia and fibula bones, using one or moreplates. The plate is held against the fractured bone with screws, forexample, which engage the bone and heads which provide a compressiveforce against the plate. The plate and bone are thus forced against eachother in a manner that transfers load primarily between a bonecontacting surface of the plate and the bone surface to reinforce thefractured bone during healing. This manner of plating generally createsrelatively low stress concentration in the bone, as there may be a largecontact area between the plate and the diaphyseal bone surfacepermitting transfer of load to be dispersed. There may be a desire touse locking screws, non-locking screws, or a combination of both thatare able to dynamically compress the bone. Of course, the designs of theplates, types of screws, and locking and/or non-locking capabilities mayvary based on the location and type of fracture.

Accordingly, there is a need for plating systems that providestabilization to the appropriate anatomical area while providingappropriate locking and/or unlocking capability for dynamic compressionof the bone.

SUMMARY

This Summary is provided to introduce a selection of concepts in asimplified form that are further described below in the DetailedDescription. This Summary is not intended to identify key features oressential features of the claimed subject matter, nor is it intended tobe used to limit the scope of the claimed subject matter.

According to embodiments, a stabilization system may include a pluralityof plates configured to fix bone in the treatment of ankle fractures.Anatomic bone plates facilitate the well-known and established treatmentmethods for bone fractures. An advantage of the exemplary stabilizationsystems is the availability to use various treatment options. It isoften a surgeon's preference whether to use a screw or a suture buttonsystem to repair a syndesmosis, and it is advantageous to provide aplate that can accept either.

In one embodiment, the stabilization system comprises a bone platehaving an upper surface and a lower surface configured to be in contactwith bone. The bone plate has a through-opening extending from the uppersurface to the lower surface. The through-opening includes a threadedportion proximate to the lower surface and a non-threaded portionproximate to the upper surface. A fastener is configured to engage thethrough-opening and to secure the bone plate to the bone. Thethrough-opening is configured to receive one of a locking fastener and acompression fastener.

In an alternative embodiment, the stabilization system comprises a boneplate having an upper surface and a lower surface configured to be incontact with bone. The bone plate has a through-opening extending fromthe upper surface to the lower surface. The through-opening includes athreaded portion proximate to the lower surface and a non-threadedportion proximate to the upper surface. A locking fastener is configuredto be received by the through-opening and configured to be inserted intothe bone. The locking fastener has a threaded head portion configured tolock to the bone plate. A compression fastener is configured to bereceived by the through-opening and configured to be inserted into thebone. The compression fastener has a substantially smooth portionconfigured to dynamically compress the bone.

In still another alternative embodiment, a stabilization systemcomprises a bone plate having an upper surface and a lower surfaceconfigured to be in contact with bone. The bone plate has athrough-opening extending from the upper surface to the lower surface,wherein. The through-opening is formed by at least three differentco-axial bores including a first bore having an internal thread and afirst diameter; a second bore having an unthreaded conical side wall anda second diameter, greater than the first diameter; and a third borehaving an annular surface surrounding the side wall and a thirddiameter, greater than the second diameter.

BRIEF DESCRIPTION OF THE DRAWINGS

Other aspects, features, and advantages of the present invention willbecome more fully apparent from the following detailed description, theappended claims, and the accompanying drawings in which like referencenumerals identify similar or identical elements.

FIG. 1 is a perspective view of a lateral distal fibula plate accordingto a first exemplary embodiment;

FIG. 2 is an enlarged view of a distal end of the lateral distal fibulaplate shown in FIG. 1 affixed to a bone;

FIG. 3 is a sectional view of a first (shaft) through-opening extendingthrough the lateral distal fibula plate shown in FIG. 1 with anon-locking fastener inserted in the through-opening;

FIG. 3A is a sectional view of the first through-opening extendingthrough the lateral distal fibula plate shown in FIG. 1 with a lockingfastener inserted in the through-opening;

FIG. 4 is a sectional view of a second (syndesmotic) hole extendingthrough the lateral distal fibula plate shown in FIG. 1;

FIG. 5 is an x-ray showing the lateral distal fibula plate shown in FIG.1 fixed to a broken fibula;

FIG. 6 is a perspective view of a posterolateral distal fibula plateaccording to a second exemplary embodiment;

FIG. 7 is a perspective view of a hook plate according to a thirdexemplary embodiment;

FIG. 8 is an enlarged perspective view of a distal end of the hook plateshown in FIG. 7;

FIG. 9 is a side elevational view of the distal end of the hook plateshown in FIG. 8; and

FIG. 10 is a perspective view of a combination depth gauge and drillguide instrument used to fix the plates of the present embodiments tobone.

DETAILED DESCRIPTION

In the drawings, like numerals indicate like elements throughout.Certain terminology is used herein for convenience only and is not to betaken as a limitation on the present invention. The terminology includesthe words specifically mentioned, derivatives thereof and words ofsimilar import. The embodiments illustrated below are not intended to beexhaustive or to limit the invention to the precise form disclosed.These embodiments are chosen and described to best explain the principleof the invention and its application and practical use and to enableothers skilled in the art to best utilize the invention.

Reference herein to “one embodiment” or “an embodiment” means that aparticular feature, structure, or characteristic described in connectionwith the embodiment can be included in at least one embodiment of theinvention. The appearances of the phrase “in one embodiment” in variousplaces in the specification are not necessarily all referring to thesame embodiment, nor are separate or alternative embodiments necessarilymutually exclusive of other embodiments. The same applies to the term“implementation.”

As used in this application, the word “exemplary” is used herein to meanserving as an example, instance, or illustration. Any aspect or designdescribed herein as “exemplary” is not necessarily to be construed aspreferred or advantageous over other aspects or designs. Rather, use ofthe word exemplary is intended to present concepts in a concretefashion.

Additionally, the term “or” is intended to mean an inclusive “or” ratherthan an exclusive “or”. That is, unless specified otherwise, or clearfrom context, “X employs A or B” is intended to mean any of the naturalinclusive permutations. That is, if X employs A; X employs B; or Xemploys both A and B, then “X employs A or B” is satisfied under any ofthe foregoing instances. In addition, the articles “a” and “an” as usedin this application and the appended claims should generally beconstrued to mean “one or more” unless specified otherwise or clear fromcontext to be directed to a singular form.

Unless explicitly stated otherwise, each numerical value and rangeshould be interpreted as being approximate as if the word “about” or“approximately” preceded the value of the value or range.

The use of figure numbers and/or figure reference labels in the claimsis intended to identify one or more possible embodiments of the claimedsubject matter in order to facilitate the interpretation of the claims.Such use is not to be construed as necessarily limiting the scope ofthose claims to the embodiments shown in the corresponding figures.

It should be understood that the steps of the exemplary methods setforth herein are not necessarily required to be performed in the orderdescribed, and the order of the steps of such methods should beunderstood to be merely exemplary. Likewise, additional steps may beincluded in such methods, and certain steps may be omitted or combined,in methods consistent with various embodiments of the present invention.

Although the elements in the following method claims, if any, arerecited in a particular sequence with corresponding labeling, unless theclaim recitations otherwise imply a particular sequence for implementingsome or all of those elements, those elements are not necessarilyintended to be limited to being implemented in that particular sequence.

Also for purposes of this description, the terms “couple,” “coupling,”“coupled,” “connect,” “connecting,” or “connected” refer to any mannerknown in the art or later developed of joining or connecting two or moreelements directly or indirectly to one another, and the interposition ofone or more additional elements is contemplated, although not required.Conversely, the terms “directly coupled,” “directly connected,” etc.,imply the absence of such additional elements.

The present disclosure provides embodiments of plates, securing devices,systems, and associated methods that can be used to repair, for example,bone fractures, particularly ankle fractures.

Specifically, embodiments are directed to bone plating with lockingand/or non-locking fasteners for dynamic compression of bone. The holedesigns may allow for fixed angle and/or polyaxial locking and/ornon-locking of the fasteners. Some embodiments include locking fastenerswith self-forming threads configured to displace the plate material,thereby locking the fastener to the plate.

While exemplary embodiments of the plates are used to repair anklefractures, those skilled in the art will recognize that the plates maybe adapted to contact one or more of a femur, a distal tibia, a proximaltibia, a proximal humerus, a distal humerus, a clavicle, a fibula, anulna, a radius, bones of the foot, bones of the hand, or other suitablebone or bones. The bone plate may be curved, contoured, straight, orflat. The plate may have a head portion that is contoured to match aparticular bone surface, such as a metaphysis or diaphysis, flares outfrom the shaft portion, forms an L-shape, T-shape, Y-shape, etc., withthe shaft portion, or that forms any other appropriate shape to fit theanatomy of the bone to be treated.

The bone plate may be comprised of titanium, stainless steel, cobaltchrome, carbon composite, plastic or polymer—such aspolyetheretherketone (PEEK), polyethylene, ultra high molecular weightpolyethylene (UHMWPE), resorbable polylactic acid (PLA), polyglycolicacid (PGA), combinations or alloys of such materials or any otherappropriate material that has sufficient strength to be secured to andhold bone, while also having sufficient biocompatibility to be implantedinto a body. Similarly, the fasteners may be comprised of titanium,cobalt chrome, cobalt-chrome-molybdenum, stainless steel, tungstencarbide, combinations or alloys of such materials or other appropriatebiocompatible materials. Although the above list of materials includesmany typical materials out of which bone plates and fasteners are made,it should be understood that bone plates and fasteners comprised of anyappropriate material are contemplated.

The embodiments of the disclosure and the various features andadvantageous details thereof are explained more fully with reference tothe non-limiting embodiments and examples that are described and/orillustrated in the accompanying drawings and detailed in the followingdescription. The features of one embodiment may be employed with otherembodiments as the skilled artisan would recognize, even if notexplicitly stated herein. Descriptions of well-known components andprocessing techniques may be omitted so as to not unnecessarily obscurethe embodiments of the disclosure. The examples used herein are intendedmerely to facilitate an understanding of ways in which the disclosuremay be practiced and to further enable those of skill in the art topractice the embodiments of the disclosure. Accordingly, the examplesand embodiments herein should not be construed as limiting the scope ofthe disclosure, which is defined solely by the appended claims andapplicable law.

Referring to FIGS. 1-5, a lateral distal fibula plate 100 (“plate 100”)according to a first exemplary embodiment is shown. Referringspecifically to FIGS. 2 and 5, plate 100 is fixed to the lateral surface52 of a fibula 50. Plate 100 may be used to treat fractures of thedistal fibula 50 and/or disruption of the syndesmosis, and can have apre-contoured shape, such as is shown in FIG. 1. Alternatively, plate100 can be contoured prior to use in order to conform to a particularbone structure.

Plate 100 has an elongate body 102 extending generally along a centrallongitudinal axis 104. Plate 100 has an upper surface 106 extendingbetween a proximal end 108 and a distal end 110 and a lower surface 107configured to be in contact with bone. A body portion 112 extendsbetween proximal end 108 and distal end 110 and has a transition section113 where body portion 112 transitions from a generally planar portion109 proximate to proximal end 108 and a contoured portion 111 proximateto distal end 110.

As used herein, the term “contoured” means “curved” such that contouredportion 111 includes surfaces (upper surface 106, lower surface 107, orboth) with non-infinite radii. The contours do not necessarily need tobe constant; the radius of curvature of contoured portion 111 can varyalong the length and width of contoured portion 111. In an exemplaryembodiment, contoured portion 111 can be contoured to match the contoursof the bone to which plate 100 is to be fixed, such as a fibula.

In an exemplary embodiment, proximal end 108 and distal end 110 eachincludes a smooth, rounded ends and edges. Body portion 112 iscontoured, with smooth, rounded edges. The smooth, rounded ends andedges eliminate the potential for inadvertently engaging and ripping anyadjoining tissue.

Body portion 112 also includes a plurality of different types ofthrough-openings formed therein and extending from upper surface 106 tolower surface 107. The different types of through-openings disclosed inplate 100 will discussed from proximal end 108 to distal end 110,although those skilled in the art will recognize that thethrough-openings can be located at different places, in differentorders, and intermixed together throughout the length of plate 100.

Referring to FIG. 3, through-openings 114 are shaft holes including athreaded portion 116 proximate to lower surface 107 and a non-threadedportion 118 proximate to upper surface 106. Through-openings 114 mayextend along longitudinal axis 104.

Threaded portion 116 and non-threaded portion 118 are co-axial. Theshaft holes can accept both locking and non-locking screws, resulting ina “stacked” design, in which a non-locking hole geometry, non-threadedportion 118, is on top of locking threaded portion 116 below.

Through-openings 114 can alternatively receive fasteners comprised oflocking screws or non-locking (compression) screws. In exemplaryembodiments, screw 160 can be 3.5 mm or 4.0 mm screws, for example.

FIG. 3 shows a non-locking screw 160 inserted into through-opening 114.Non-threaded portion 118 is generally conical in shape such thatnon-threaded portion 118 is wider near upper surface 106 of plate 100and narrower toward threaded portion 116. Screw 160 has a substantiallysmooth convex portion 162 of a head 164 configured to be received by andengage with non-threaded portion 118 and to dynamically compress bone 50after fixation of plate 100 to bone 50. Non-threaded portion 118 has agenerally concave surface 119 to mate with convex surface portion 162 ofhead 164 of screw 160.

A shaft 166 of screw 160 has distal threads 168 that are configured toscrew into bone 50. Shaft 166 and threads 168 have a narrower diameterthan that of through-opening 114 so that shaft 166 can pass throughthrough-opening 114 without engaging threaded portion 116 ofthrough-opening 114.

A locking screw 170 is shown in FIG. 3A. Locking screw 170 has athreaded head portion 172 configured to engage threaded portion 116 ofthrough-opening 114 and to lock screw 170 to plate 100. Threaded headportion 172 is a self-forming thread that is configured to displacematerial in threaded portion 116 of plate 100 to lock fastener 170 toplate 100.

A second type of through-opening 120, shown in FIG. 1, may be sized anddimensioned to allow a K-wire 174 to pass therethrough. In an exemplaryembodiment, through-opening 120 is sized to allow a 1.6 mm K-wire, topass therethrough, although those skilled in the art will recognize thatother size through-openings 120 can be provided for other size K-wires.As noted in FIG. 1, one or more through-openings 120 are spaced along alength of plate 100 and are not necessarily aligned with longitudinalaxis 104.

A third type of through-opening that can be provided in plate 100 is anelongate slot 130. Elongate slot 130 may extend along longitudinal axis104, for example. Elongate slot 130 may allow for a range of securingmember insertion locations. In an exemplary embodiment, one elongatethrough-opening 130 is provided, although those skilled in the art willrecognize, depending on the length of plate 100 and through-opening 130,one or more than through-opening 130 can be provided.

Slots 130 include generally smooth side walls to allow a securingmember, such as screw 160, to be inserted at infinite locations alongthe length of each slot 130. A rib 132 extends around the innerperimeter of slot 130 below upper surface 106. In an exemplaryembodiment, screws 130 can be 3.5 mm or 4.0 mm non-locking screws andcan provide up to 1 mm of compression or distraction. Screws 160 mayengage rib 132 along under surface 162 of head 164 of screw 160 so thathead 164 is largely, if not entirely, within slot 130 to minimize theamount of head 162 extending above upper surface 106 of plate 100.

Referring to FIGS. 1 and 4, a fourth type of through-opening that can beprovided in plate 100 is a syndesmotic hole 140 located at transitionportion 113. Syndesmotic hole 140 can accept three different types offixation: (1) a suture button 190; (2) non-locking screw 160; or (3)locking screw 170.

Referring specifically to the cross-section of hole 140 in FIG. 4, hole140 includes, from lower surface 107 of plate 100 to upper surface 106of plate 100, at least three different co-axial bores. A first boreincludes a threaded portion 142, similar to threaded portion 116 ofthrough-opening 114, with its bore having a first diameter D1.

Similar to through-opening 114, a second bore of hole 140 is has anunthreaded conical portion 144 with a conical side wall 146 locatedabove and adjacent to threaded portion 142. The second bore of hole 140has a maximum diameter D2, larger than diameter D1.

In contrast to through-opening 114, hole 140 further includes a thirdbore comprising a bowl portion 150 having a diameter D3, larger thanmaximum diameter D2. Bowl portion 150 is fur the use of a suture buttonsystem that includes two metal buttons 190, 196, connected via suture.Button 196 interfaces with the far cortex of bone 50 (shown in FIG. 5),while button 190 interfaces with bone plate 100. This button systemprovides stability for a disrupted joint or bone fracture and alsoprovides a type of mobile stability. The use of buttons 190, 196 may bea method of treatment for the syndesmosis when the syndesmosis isdisrupted. Another type of fixation of a disrupted syndesmosis is a bonescrew as described above, which is a more rigid fixation than the suturebutton system.

Referring to FIG. 4, bowl portion 150 is above and adjacent to conicalportion 146. Conical portion 146 has a maximum diameter of diameter D2proximate to bowl portion 150. Bowl portion 150 comprises a bowldiameter, larger than the maximum diameter. The transition between bowlportion 150 and threaded portion 142 (i.e. conical portion 144) is shownin FIG. 4 as a chamfer, but could alternatively be a round.

Bowl portion 150 includes a side wall 152 that circumscribes bowlportion 150 and an annular surface 154 between the side wall 152 andconical portion 144. Annular surface 154 surrounds side wall 146 ofconical portion 144. Bowl portion 150 is configured to receive andretain a button 190 having a lower surface 192 (shown in FIG. 5)configured to engage annular surface 154 and fit within side wall 152.

Referring to FIG. 1, button 190 also includes at least one thread hole194 that is in communication with hole 140 when lower surface 192 is inengagement with annular surface 154.

Referring to FIG. 5, first button 190 is configured for insertion intobowl portion 150 of hole 140 and a second button 196 is configured toengage bone 50, distal from bone plate 100. A suture (not shown) extendsthrough thread hole 194, through plate 100 and a passage 54 drilledthrough bone 50, to second button 196 to compress bone 50 and plate 100between buttons 190, 196.

A fifth set of through holes 158 are provided at distal end 110 of plate1000. Holes 158 may be configured to receive locking screws 198. In anexemplary embodiment, holes 158 may be threaded to accept 2.5 mm lockingscrews 198, for example. A plurality of holes 158 (about seven as shownin plate 100) are provided to fix distal end 110 of plate 100 securelyin bone 50. Holes 158 are not constrained along longitudinal axis 104but instead are located along the width of plate 100 to provide aplurality of screw connections for a secure fixation to bone.

A second embodiment of a plate 200, shown in FIG. 6, is a posterolateraldistal fibula plate. Plate 200 sits on the posterior face of the fibuladistally, and wraps around to the lateral surface as plate 200 travelsproximally. Plate 200 can be used to facilitate s posterior surgicalapproach. Similar to plate 100, plate 200 can have a variety ofdifferent through-openings, including syndesmotic holes 240, similar tosyndesmotic holes 140 described above.

Plate 200 has a generally planar body 202 with a transition portion 204proximate to syndesmotic holes 240, where body 202 transitions to acontoured shape to conform to the posterior face of the fibula.

A third embodiment of a hook plate 300 (“plate 300”) is shown in FIGS.7-9. Plate 300 can be used for very distal fractures of the tibia orfibula, for example. Hook plate 300 has an elongate body 302 extendinggenerally along a central longitudinal axis 304. Plate 300 has agenerally planar top surface 306 extending between a proximal end 308and a distal end 310. A body portion 312 extends between proximal end308 and distal end 310. Plate 300 is symmetrical about a plane extendingthrough central longitudinal axis 304 perpendicular to top surface 306.

In an exemplary embodiment, proximal end 308 includes a smooth, roundedface. The smooth, rounded face eliminates the potential forinadvertently engaging and ripping any adjoining tissue.

Body portion 312 is generally planar, with smooth, rounded surfaces,again to eliminate the potential for inadvertently engaging and rippingany adjoining tissue. Body portion 312 also includes a plurality ofthrough-openings 314 formed therein. Through-openings 314 are elongateslots and allow for a range of securing member insertion locations. Inan exemplary embodiment, two elongate through-openings 314 are provided,although those skilled in the art will recognize, depending on thelength of plate 300 and through-openings 314, more or less than twothrough-openings 314 can be provided.

Through-openings 314 include generally smooth side walls to allowsecuring members 318 to be inserted at infinite locations along thelength of each through-opening 314. A rib 320 may extend around theinner perimeter of through-opening 314 below top surface 306. In anexemplary embodiment, securing members 318 can be 3.5 mm or 4.0 mmnon-locking screws and can provide up to 1 mm of compression ordistraction. Securing members 318 engage rib 320 along an under surfaceof the head 322 of securing member 318 so that head 322 is largely, ifnot entirely, within through-opening 314 to minimize the amount of head322 extending above top surface 306 of plate 300.

Through-openings 316 may be located at either end of plate 300.Through-openings 316 are shaft holes that can accept either one oflocking and non-locking screws via the “stacked” design described above.A first through-opening 316 is located at proximal end 308 and a secondthrough-opening 316 is located at distal end 310.

Referring to FIGS. 8 and 9, distal end 310 includes an arcuate surface330 that extends away from the plane of body portion 312, and is used tocapture the distal bone fragment of either the tibia or the fibula.Arcuate surface 330 extends in an arc having an angle β of between about100 degrees and about 160 degrees, about 125 degrees and about 155degrees, or about 135 degrees and about 150 degrees from body portion312. At least one through-opening 316 extends through arcuate surface330.

A most distal end 332 of arcuate surface 330 includes a hook assemblyhaving two separate hooks 334, 336. Each hook 334, 336 includes a flatsurface 335, 337, respectively and each flat surface 335, 337 includes acorresponding cutting edge 338, 340, respectively. Cutting edges 338,340 extend along a single line 342 that is perpendicularly skew tolongitudinal axis 304 and are used to engage and dig into bone materialin the tibia or fibula.

With the exception of cutting edges 338, 340, all edges of arcuatesurface 330 and hooks 334, 336 have smooth, rounded surfaces, again toeliminate the potential for inadvertently engaging and ripping anyadjoining tissue.

The bone plates 100, 200, 300 described herein may be especiallyconfigured for treatment of an ankle fracture. In particular, theseplates 100, 200, 300 may be especially suitable for treatment of thedistal fibula including lateral distal fibula or the posterolateraldistal fibula, and/or the distal tibia. These anatomic bone plates 100,200, 300 may facilitate improved treatment methods of ankle fracturesand can provide a number of treatment options based on surgeonpreference.

FIG. 10 shows a combination depth gauge and drill guide instrument 400(“instrument 400”) that can be used with any of plates 100, 200, 300described above, as well as other bone plates not shown. Instrument 400is used to determine how far to drill into a bone for fixation of one ofplates 100, 200, 300.

Instrument 400 has an elongate body 402 with a proximal end 404, adistal end portion 406, and a body 408 extending between proximal end404 and distal end portion 406. Body 408 includes a hollow passage 410for communication between proximal end 404 and distal end portion 406.Passage 410 is large enough to allow a drill (not shown) to be insertedinto instrument 500 at proximal end 404, through body 408, and out adistal tip 412 at distal end portion 406. In an exemplary embodiment,passage 410 is an open slot. In an alternative exemplary embodiment,passage 410 can be a closed passage along the length of body 402, with atransparent portion (not shown) to allow visualization of the drillwithin passage 410.

Body 408 includes indicia 414 printed thereon to indicate how far a tipof the drill has bored into the bone. In an exemplary embodiment,indicia 414 is a series of spaced lines extending transverse todirection of passage 410, with the spacing of the lines in millimeters,and indicator numbers are provided for each line.

Distal tip 412 may be configured to thread into a threaded hole, suchas, for example, through-opening 114, 240, 316 on bone plate 100, 200,300, respectively. A drill (not shown) may then be placed throughpassage 410 in instrument 400 and used to drill a pilot hole for ascrew. The drill is calibrated and has a depth marking on its shaft thatcorresponds to an indicia line and its associated numerical value toindicate to determine the length of the screw to be used with plate 100,200, 300. Passage 410 is used to see the marking on the drill. Thisfeature saves a step in drilling and measuring, combining these twosteps into the same step, as the prior art standard is to have adedicated drill guide as a first instrument, and a dedicated depth gaugeas a second instrument.

Although the invention has been described in detail and with referenceto specific embodiments, it will be apparent to one skilled in the artthat various changes and modifications can be made without departingfrom the spirit and scope of the invention. Thus, it is intended thatthe invention covers the modifications and variations of this inventionprovided they come within the scope of the appended claims and theirequivalents. It is expressly intended, for example, that all rangesbroadly recited in this document include within their scope all narrowerranges which fall within the broader ranges. It is also intended thatthe components of the various devices disclosed above may be combined ormodified in any suitable configuration.

What is claimed is:
 1. A stabilization system comprising: a bone platehaving an upper surface and a lower surface configured to be in contactwith bone, the bone plate having a through-opening extending from theupper surface to the lower surface, the through-opening including athreaded portion proximate to the lower surface and a non-threadedportion proximate to the upper surface; and a fastener configured toengage the through-opening and to secure the bone plate to the bone,wherein the through-opening is configured to receive one of a lockingfastener and a compression fastener.
 2. The stabilization systemaccording to claim 1, wherein the non-threaded portion is generallyconical in shape such that the non-threaded portion is wider near theupper surface of the plate and narrower toward the threaded portion. 3.The stabilization system according to claim 2, wherein the non-threadedportion has a generally concave surface.
 4. The stabilization systemaccording to claim 1, wherein the threaded portion and the non-threadedportion are co-axial.
 5. The stabilization system according to claim 1,wherein the locking fastener has a threaded head portion configured toengage the threaded portion and to lock to the bone plate.
 6. Thestabilization system according to claim 1, wherein the compressionfastener has a substantially smooth head portion configured to engagethe non-threaded portion and to dynamically compress the bone.
 7. Thestabilization system according to claim 1, wherein the non-threadedportion comprises a conical portion, adjacent to the threaded portionand a bowl portion, adjacent to the conical portion.
 8. Thestabilization system according to claim 7, wherein the conical portionhas a maximum diameter proximate to the bowl portion and wherein thebowl portion comprises a bowl diameter, larger than the maximumdiameter.
 9. The stabilization system according to claim 7, wherein thebowl portion comprises a side wall and an annular surface between theside wall and the conical portion.
 10. The stabilization systemaccording to claim 7, wherein the bowl portion is configured to receiveand retain a button located on the annular surface and within the sidewall.
 11. The stabilization system according to claim 10, wherein thecompression fastener comprises a button having a lower surfaceconfigured to engage the annular surface and at least one thread hole incommunication with the through-hole when the lower surface is inengagement with the annular surface.
 12. The stabilization system ofclaim 1, wherein the threaded head portion is a self-forming threadconfigured to displace material in the threaded portion of the plate tolock the fastener to the plate.
 13. A stabilization system comprising: abone plate having an upper surface and a lower surface configured to bein contact with bone, the bone plate having a through-opening extendingfrom the upper surface to the lower surface, the through-openingincluding a threaded portion proximate to the lower surface and anon-threaded portion proximate to the upper surface; a locking fastenerconfigured to be received by the through-opening and configured to beinserted into the bone, wherein the locking fastener has a threaded headportion configured to lock to the bone plate; and a compression fastenerconfigured to be received by the through-opening and configured to beinserted into the bone, wherein the compression fastener has asubstantially smooth portion configured to dynamically compress thebone.
 14. The stabilization system according to claim 13, wherein thenon-threaded portion comprises a conical portion, adjacent to thethreaded portion and a bowl portion, adjacent to the conical portion.15. The stabilization system according to claim 14, wherein thecompression fastener is configured to be received by the conicalportion.
 16. The stabilization system according to claim 14, wherein thecompression fastener is configured to be received by the bowl portion.17. The stabilization system according to claim 16, wherein thecompression fastener comprises a first button configured for insertioninto the bowl portion and a second button configured to engage the bone,distal from the bone plate.
 18. The stabilization system according toclaim 13, wherein the threaded head portion is a self-forming threadconfigured to displace material of the plate to lock the fastener to theplate.
 19. A stabilization system comprising a bone plate having anupper surface and a lower surface configured to be in contact with bone,the bone plate having a through-opening extending from the upper surfaceto the lower surface, wherein the through-opening is formed by at leastthree different co-axial bores including: a first bore having aninternal thread and a first diameter; a second bore having an unthreadedconical side wall and a second diameter, greater than the firstdiameter; and a third bore having an annular surface surrounding theside wall and a third diameter, greater than the second diameter. 20.The stabilization system according to claim 19, further comprising atleast one of: a locking fastener configured to be received by thethrough-opening and configured to be inserted into the bone, wherein thelocking fastener has a threaded head portion configured to lock to thebone plate at the internal thread; and a compression fastener configuredto be received by the through-opening and configured to be inserted intothe bone, wherein the compression fastener has a substantially smoothportion configured to engage one of the conical side wall and theannular surface and dynamically compress the bone.